Myocardial fibrosis and coronary calcifications caused by endurance exercise? Insights from former professional cyclists
Open accessAbstract
PURPOSE: This study aimed to compare the prevalence of myocardial fibrosis and coronary calcification in individuals who have performed very high levels of strenuous endurance exercise (SEE; former male professional cyclists) and sex/age-matched controls. METHODS: We used a retrospective cohort study design, where cases were former finishers of ≥1 Grand Tour (Tour de France, Giro d' Italia or Vuelta a España) and controls were untrained individuals free of cardiovascular risk. All participants underwent cardiac magnetic resonance and cardiac computer tomography in the same center during years 2020-2021 to detect myocardial fibrosis (late gadolinium enhancement) and to quantify coronary calcium, respectively. RESULTS: Twenty-three cases (age, 46 ± 6 yr) and 59 controls (47 ± 7 yr) were studied. Fibrotic patches were evidenced only in the left ventricle, with a higher prevalence in cases (23% vs 2% in controls, P = 0.006). However, fibrotic tissue was nonischemic and of low extension (0.6% ± 0.4% of left ventricle mass), and no significant differences were found between cases and controls for native T1 or T2 values. No between-group differences were found for coronary calcium indicators, including Agatston or density scores. Subanalyses revealed no differences attending to whether cases were still performing regular SEE ( n = 8) or not ( n = 15) after professional retirement. CONCLUSIONS: Although former professional cyclists seemed to show a greater prevalence of myocardial fibrosis, the extension of fibrotic tissue was minimal and no alterations were found in coronary calcification indicators. While keeping in mind the low sample size of the cases' group, our results do not support evidence for major cardiac maladaptations with long-term exposure to SEE, at least in middle-age adults.
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Atherosclerotic plaques might not necessarily have the same clinical relevance in athletes and nonathletes, as they are often more calcific in athletes.
“atherosclerotic plaques might not necessarily have the same clinical relevance in athletes and nonathletes, as they are often (but not always 34 ) more calcific--which are considered more stable and less prone to rupture--in the former.35,36”
From Exercise benefits in cardiovascular diseases: From mechanisms to clinical implementation (2023) · cites this paper as [34]
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Kiningham, R. B. (2023) · Current Sports Medicine Reports · doi:10.1249/jsr.0000000000001039
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- Authors
- MACEIRA, A., VALENZUELA, P. L., SANTOS-LOZANO, A., GARCÍA-GONZÁLEZ, M. P., ORTEGA, L. H., DÍAZ-GONZALEZ, L., BORAITA, A., BARRANCO-GIL, D., & LUCIA, A.
- Affiliations
- Ascires Grupo Biomédico, Valencia, SPAIN
- Research Institute Hospital 12 de Octubre (ES)
- Department of Cardiology, Sports Medicine Center, Spanish Agency for Health Protection in Sports, Madrid, SPAIN
- Faculty of Sport Sciences, Universidad Europea de Madrid, Madrid, SPAIN
- Venue
- Medicine & Science in Sports & Exercise
- Published
- 2022-09-22
- Volume
- 55
- Issue
- 2
- Pages
- 151-157
- ISSN
- 0195-9131 (ISSN-L)
- 1530-0315
- OpenAlex
- W4296688432
- Cited by
- 9
- References
- 39
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 1 · 2023: 4
- FWCI
- 1.22
- Type
- journal article
- Language
- en
- Open access
- green
- hdl.handle.net
- Licence
- other-oa
- Locations
- Medicine & Science in Sports & Exercise (publishedVersion)
- PubMed (publishedVersion)
- RUIdeRA - Institutional University Repository (University of Castilla-La Mancha) (submittedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Effects of Exercise
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Cardiac Imaging and Diagnostics
- Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
- Keywords
- myocardial fibrosis, coronary artery calcification, endurance exercise, professional cyclists, late gadolinium enhancement, cardiac magnetic resonance, coronary computed tomography, exercise-induced cardiac remodeling, left ventricular fibrosis, middle-aged adults
- MeSH terms
- Adult, Bicycling, Calcium, Contrast Media, Fibrosis, Gadolinium, Humans, Male, Middle Aged, Cardiomyopathies, Myocardium, Physical Endurance, Predictive Value of Tests, Retrospective Studies
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